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The first match of the Italian national basketball team was played on 4 April 1926 in Milan, and it ended with a victory over France by 23–17.
Italy's first participation in the Olympic Games was at the 1936 Summer Olympics in Berlin, placing seventh out of twenty-one teams. At the EuroBasket 1937 Italy placed second behind Lithuania, after being beaten by just one point in the final game. The silver medal was repeated at EuroBasket 1946.

Following the end of World War II the Azzurri went through difficult times and not only failed to qualify for two Summer Olympics and three consecutive world championships but struggled in Europe as well. This was also reflected at the technical level with the alternation of several head coaches within only a few years. Of special importance was Italy's decision not to compete at the EuroBasket 1949, to mourn for the victims of the Superga air disaster. It was the first time that the squad missed a EuroBasket.

In 1957 as Nello Paratore took the head coach position (which he held for 11 years) Italy made only slight improvements from the previous decade.

At the 1960 Summer Olympics in Rome Italy showed its most impressive performance to this point where it placed fourth, only behind USA, USSR and Brazil. Curiously, the organizational expenses of the Olympics in Rome resulted in the decision not to participate in the EuroBasket 1961.

In 1969, Giancarlo Primo became Italy's coach, focusing the game strategies on defense. Under his leadership Italian national team grew stronger, claiming a place among the world's best teams. Under Primo, the Azzuri won two European bronze medals and earned two fourth places at FIBA World Championship. Further, Italy finished fourth at the 1972 Summer Olympics where it lost the match for third place to Cuba by only one point.
Among the leading players of the national team were the young Meneghin, Marzorati, Villalta and Bariviera.

In 1979 Sandro Gamba replaced Primo, leading Italy to its biggest triumphs till then: a silver at the 1980 Summer Olympics in Moscow, a gold at EuroBasket 1983 in Nantes, and a bronze at the EuroBasket 1985 in Stuttgart.
As in the years before, Meneghin, Marzorati and Villalta were the cornerstones of the team, complemented by players such as Riva and Brunamonti. This episode in time stands out to this day as the most successful in the history of the Italian national team.

Following these outstanding accomplishments was another period of crisis, first under Coach Valerio Bianchini (replaced in 1985), and then another six years of modest success where the biggest accomplishment was silver at the EuroBasket 1991 in Rome, which was called to end Ettore Messina, who took over in 1992. In the same year Enrico Vinci stepped down as President of the Italian Basketball Federation after 16 years. The place was taken over by Giovanni Petrucci.

Ettore Messina became Italy's coach in 1992, winning a silver medal at EuroBasket 1997 in Barcelona. This medal was the main accomplishment of coach Messina, who served the team for five years and failed to qualify for the Olympic Games and the World Championship.
A great disappointment was suffered at the 1998 FIBA World Championship in Athens when a team with Fučka, Myers and Meneghin was believed to aspire to the podium but only finished sixth. Bogdan Tanjević replaced Messina, leading Italy to the triumph at EuroBasket 1999, the first gold medal in 16 years. The second gold medal at a European Basketball Championship arrived after beating Spain in the final game. After a ninth place at EuroBasket 2001, held in Turkey, Carlo Recalcati was called to replace Tanjević.
Recalcati could count on Italy's top talents Gregor Fučka and Carlton Myers, as well as valuable contributors such as Basile, Abbio and Chiacig.

At EuroBasket 2003, Italy showed a strong performances and defeated Germany and Greece but was later kicked out by Spain in the semifinals. The victory against France in the bronze medal game guaranteed the team's qualification at the 2004 Summer Olympics in Athens. Italy won a silver medal in that event and was stopped only in the final game by Argentina. Most important, this silver seemed to be worth much more than that of the 1980 Olympics in Moscow where several top teams, including the United States and Canada were absent for a boycott.
Since then, the Azzurri experienced years of only skimpy satisfaction: after the Summer Olympics in Greece, the team collected three ninth places, two at the EuroBasket and one at the 2006 World Cup. Subsequently, the team failed to qualify for the 2008 Beijing Olympics, for the 2009 EuroBasket and the World Championship the following year.
Despite the increasing internationalization of the NBA (especially towards European players) and a steady presence of Italian players, (including the historic first overall pick Andrea Bargnani of the 2006 NBA Draft) the national team performed poorly in these years. The reasons for this phenomenon are simple: low contribution of NBA athletes, ageing guards (Massimo Bulleri and Gianluca Basile, who were the highlights of Athens already in their thirties) and the lack of young talent. The reason for the seeming lack of talent were caused by the difficulty that Italian talents had in the national championships Serie A. There, they faced strong competition especially from American and European players. It comes as no coincidence that the team that absolutely dominated in the last years, Montepaschi Siena rarely had Italians in the starting lineup.
During these years, the Serie A went through some changes at the top executives level. Fausto Maifredi (in office since 1999) left and the Federation's first commissioner Dino Meneghin changed the rules by mandating for the commissioner to be the league's president as well.
Meanwhile, Italy failed to qualify for EuroBasket 2009 for the first time since 1961. Curiously, 2009 is the first year where the Azzurri failed to qualify for sports-related reasons. Both absences (1949 and 1961) were due non-sporting reasons. Following the disappointment CT Recalcati left and was replaced by Simone Pianigiani. Pianigiani currently coaches both the national team and Mens Sana Basket, which for years dominated the Serie A.

In 2017, Coach Messina and his players were able to lock up third place in Group B of the EuroBasket 2017 and set up a Round of 16 date with Finland.[5] They reached the Quarterfinals, but Serbia wound up booking a Semi-Finals clash with Russia after an 83-67 victory over a cold-shooting performance from Italy.[6]

On 15 June 2017, Messina announced he would leave the bench of Italy's national team after Eurobasket 2017.[7]